FORMAT LAPORAN DISKUSI REFLEKSI KASUS (DRK)

RUANG RAWAT : ...........................................

Nama Ruangan :
Tanggal Pelaksanaan :
Topik Diskusi Kasus :

A. Masalah/ Isu yang Muncul :

...................................................................................................................
...................................................................................................................
...................................................................................................................
...................................................................................................................

B. Pembahasan:
...................................................................................................................
...................................................................................................................
...................................................................................................................
...................................................................................................................

C. Rencana Tindak Lanjut:

Isu Kegiatan Indikator

No
1.

2.

3.

4.
Peserta DRK

1.

(......................................)

(.......................................)

(.......................................)

(........................................)

dst

(........................................)

............,................
Kepala Ruangan

( .........................)